Supervisor, Patient Access/Billing

Hackensack Meridian Health•Hasbrouck Heights, NJ

42d

About The Position

Our team members are the heart of what makes us better. At Hackensack Meridian Health we help our patients live better, healthier lives — and we help one another to succeed. With a culture rooted in connection and collaboration, our employees are team members. Here, competitive benefits are just the beginning. It’s also about how we support one another and how we show up for our community. Together, we keep getting better - advancing our mission to transform healthcare and serve as a leader of positive change. The Physician Billing Supervisor Reports directly to the Manager, PB Network Revenue Operations. Has primary responsibility for the billing operations and claim submissions for all HMH practices; this includes team member supervision, departmental workflow, and maintaining optimal performance of the electronic billing systems and related EPIC workflow. Identifies billing issues and recommends solutions to increase productivity, maximize cash collections, and improve the revenue cycle.

Requirements

Bachelor's degree in accounting, business, healthcare administration or a related field.
Minimum three years in a healthcare billing office or health insurance claims environment; familiar with common medical billing practices, concepts, and procedures.
Excellent analytical and critical thinking skills with attention to detail.
Ability to work in a fast paced business office; must be able to coordinate multiple projects with multiple deadlines or changing priorities.
Prior experience with an electronic billing system/claims editor.
Proficient with computer applications and spreadsheets.
Must be highly organized and possess excellent time management skills.
Excellent written and verbal communication skills.
Proficient computer skills that may include but are not limited to Microsoft Office and/or Google Suite platforms.

Nice To Haves

Proficiency with EPIC PB, claims, and Olive Reimbursement management.
Prior experience in a Patient Financial Services Department for Physician Billing or a University Medical Center/hospital.
Experience with supervision and delegating tasks.
Extensive understanding of outpatient physician and hospital billing practices.
Experience with understanding and applying logic to claim rejections, edits, and errors.

Responsibilities

Responsible for timely and accurate claim submission for the HMH network practices.
Plans, coordinates, and schedules the daily operations of the department in compliance with state and federal billing regulations.
Operates and maintains the electronic billing systems to ensure optimal performance; act as System Administrator for the applications.
Daily monitoring of the EPIC Physician Billing Dashboards, WQs, and reconciliation of all claims EDI between the clearinghouse and EPIC for HMH network practices; initiates immediate and appropriate actions when issues arise.
Monitors staff productivity and ensures timely completion of duties; establishes performance standards for billing functions.
Provides supervision for the Physician Billing Department team members.
Coordinates resolution to system issues with Information Technology and vendor Technical Support. Keeps senior leadership informed of system issues and consults for direction when necessary.
Monitors the status of unbilled accounts, monitors or delegates monitoring of billing exception reports and the unreleased claim report.
Utilizes billing system reports for analysis and corrective action of claim related issues; proactively review accounts to ensure quality of the billing data.
Immediately informs other Patient Accounting departments when an issue arises with the billing system that impacts their operations.
Responsible for specialty billing functions such as the Global arrangements, Single Case Agreements, and Corporate clients.
Oversees incoming and outgoing correspondence. Determines and implements proper course of action when needed.
Maintains current departmental policies and procedures.
Ensures team members are properly trained on their procedures and requests additional training as needed.
Responsible for interviewing, hiring, and termination of (PB) billing staff in accordance with corporate policies and procedures.
Responsible for maintaining accurate time & attendance records utilizing Peoplesoft in accordance with corporate policies.
Completes the written performance evaluations for team members; assists with goal development.
Performs testing for new or upgraded systems and applications; analyzes actual vs. expected results; prepares documentation, spreadsheets, and/or a summary of findings as necessary.
Oversees the review of all aspects of the outpatient exception report including DNB errors, coding deficiencies and any other issues affecting timely billing.
Evaluates actual vs. planned performance and metrics, presents and communicates possible opportunities.
Initiates contact with insurance companies and governmental agencies as necessary to investigate or resolve payer/edit issues.
Creates and reviews reports and operational metrics through various report engines such as Epic, Olive, and BI to assist with daily and monthly claims reconciliation process.
Builds relationships with departments and operations staff to obtain and analyze additional information to improve billing workflows.
Acts as a liaison with Physician Billing leadership by communicating with clinical and operational leaders to obtain data needed for accurate billing; follows through until issues are addressed or/and resolved.
Addresses inquiries from other HMH departments regarding Physician billing.
Maintains strictest confidentiality and adheres to all HIPAA guidelines and regulations.
Assesses the impact of new payer regulations and billing requirements, and acts as a resource to clinical departments regarding those requirements; discusses ideas with Senior Leaders.
Performs or delegates the ordering of general supplies and billing manuals.
Lifts a minimum of 5 lbs. Pushes and pulls a minimum of 5 lbs. and stands a minimum of 0 hours a day.
Other duties and/or projects as assigned.
Adheres to HMH Organizational competencies and standards of behavior.